RESEARCH ARTICLE
Survival after Locoregional Recurrence or Second Primary Breast Cancer: Impact of the Disease-Free Interval Annemieke Witteveen1*, Annemiek B. G. Kwast2, Gabe S. Sonke3, Maarten J. IJzerman1, Sabine Siesling1,2 1 Department of Health Technology and Services Research, MIRA Institute of Biomedical Technology and Technical Medicine, Twente University, Enschede, The Netherlands, 2 Department of Registration and Research, Comprehensive Cancer Centre the Netherlands (IKNL), Utrecht, the Netherlands, 3 Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands * [email protected]
Abstract
OPEN ACCESS Citation: Witteveen A, Kwast ABG, Sonke GS, IJzerman MJ, Siesling S (2015) Survival after Locoregional Recurrence or Second Primary Breast Cancer: Impact of the Disease-Free Interval. PLoS ONE 10(4): e0120832. doi:10.1371/journal. pone.0120832 Academic Editor: Yves St-Pierre, INRS, CANADA Received: November 17, 2014 Accepted: December 29, 2014 Published: April 10, 2015 Copyright: © 2015 Witteveen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The association between the disease-free interval (DFI) and survival after a locoregional recurrence (LRR) or second primary (SP) breast cancer remains uncertain. The objective of this study is to clarify this association to obtain more information on expected prognosis. Women first diagnosed with early breast cancer between 2003–2006 were selected from the Netherlands Cancer Registry. LRRs and SP tumours within five years of first diagnosis were examined. The five-year period was subsequently divided into three equal intervals. Prognostic significance of the DFI on survival after a LRR or SP tumour was determined using Kaplan-Meier estimates and multivariable Cox regression analysis. Follow-up was complete until January 1, 2014. A total of 37,278 women was included in the analysis. LRRs or SP tumours were diagnosed in 890 (2,4%) and 897 (2,4%) respectively. Longer DFI was strongly and independently related to an improved survival after a LRR (long versus short: HR 0.65, 95% CI 0.48–0.88; medium versus short HR 0.81, 95% CI 0.65–1.01). Other factors related to improved survival after LRR were younger age (
Survival after Locoregional Recurrence or Second Primary Breast Cancer: Impact of the Disease-Free Interval Annemieke Witteveen1*, Annemiek B. G. Kwast2, Gabe S. Sonke3, Maarten J. IJzerman1, Sabine Siesling1,2 1 Department of Health Technology and Services Research, MIRA Institute of Biomedical Technology and Technical Medicine, Twente University, Enschede, The Netherlands, 2 Department of Registration and Research, Comprehensive Cancer Centre the Netherlands (IKNL), Utrecht, the Netherlands, 3 Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands * [email protected]
Abstract
OPEN ACCESS Citation: Witteveen A, Kwast ABG, Sonke GS, IJzerman MJ, Siesling S (2015) Survival after Locoregional Recurrence or Second Primary Breast Cancer: Impact of the Disease-Free Interval. PLoS ONE 10(4): e0120832. doi:10.1371/journal. pone.0120832 Academic Editor: Yves St-Pierre, INRS, CANADA Received: November 17, 2014 Accepted: December 29, 2014 Published: April 10, 2015 Copyright: © 2015 Witteveen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The association between the disease-free interval (DFI) and survival after a locoregional recurrence (LRR) or second primary (SP) breast cancer remains uncertain. The objective of this study is to clarify this association to obtain more information on expected prognosis. Women first diagnosed with early breast cancer between 2003–2006 were selected from the Netherlands Cancer Registry. LRRs and SP tumours within five years of first diagnosis were examined. The five-year period was subsequently divided into three equal intervals. Prognostic significance of the DFI on survival after a LRR or SP tumour was determined using Kaplan-Meier estimates and multivariable Cox regression analysis. Follow-up was complete until January 1, 2014. A total of 37,278 women was included in the analysis. LRRs or SP tumours were diagnosed in 890 (2,4%) and 897 (2,4%) respectively. Longer DFI was strongly and independently related to an improved survival after a LRR (long versus short: HR 0.65, 95% CI 0.48–0.88; medium versus short HR 0.81, 95% CI 0.65–1.01). Other factors related to improved survival after LRR were younger age (
